Learn how SUS pays for high-cost medicines – News

Those who are unable to pay for the medicines required for their medical treatment are entitled to SUS (Integrated Health System). This benefit is part of the public health system’s Pharmaceutical Support Policy, which provides access to products through specialized pharmacies in conjunction with municipal and state health departments and the federal government.

To do this, you must have a National Health Card and a medical indication for the use of the medicine. Those who do not yet have a card must go to the UBS (Basic Health Unit) closest to their home and present copies of personal documents, such as CPF and RG, and proof of residence. In addition to medicines, this card provides access to appointments and exams.

For those who are already receiving treatment with SUS, just a medical application is enough to remove the medication from the UBS pharmacy. For each withdrawal, it is necessary to present the SUS Card, RG and medical prescription. People who have been consulted in public clinics or in public clinics that are not affiliated with the public system may also request medicines, but must first register at the local pharmacy where they wish to receive the products. Those who can’t afford it have priority.

The medicines available through SUS are listed rename (National list of essential medicines).

high-cost drugs

In the case of high-cost medicines, a medical report must be requested, in two copies, containing information on the disease, the type of treatment and the period and dose. This report assesses the application and authorization for the withdrawal of medicines in the Specialized Component of Pharmaceutical Aid.

If the report is not yet available, the patient must remove the LME form (Report of Demand, Evaluation and Authorization of the Pharmaceutical Assistance Medication) and take it to the physician for completion. . O the form is also available online.

It is essential to prove the need to use the prescribed medication. The professional must report the disease code listed in the ICD (International Classification of Diseases) and the registration number in the CRM (Regional Council of Medicine). For the form to be valid, the doctor must stamp and sign it.

There are cases in which patients need further consultation and examination to confirm the disease.

When requesting a drug, it is important to request a copy of the protocol. There is no set delivery time, which can be done in a few days or three months. Therefore, some patients will receive instructions later, by email, mail, or phone.

The patient must withdraw the expensive medication every month for three months, and always with a new prescription. After this period, the application must be re-applied for another three months, repeating the whole process.

If the health center pharmacy does not have access to the medication, or refuses to supply it, the user can still, with the help of a health care attorney, file a lawsuit in court to claim coverage.

One option, if the patient has the resources, is to buy the medicine and ask for it to be returned to court. But if you can’t afford it, the solution is to ask SUS to pay for the medicine, ”said Leandro Reimberg, a medical and health expert. request an action and order.

The São Paulo State Department of Health said in a statement that “the distribution of specialized medicines is in accordance with the protocols and guidelines agreed between the Union, the Member States and the municipalities. The necessary instructions, forms and requirements are available here link. In the context of the Specialized Component of Pharmaceutical Support, medicines are only administered to patients who meet the criteria set out in the relevant Clinical Protocol and Therapeutic Guidelines. “

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